Healthcare Provider Details

I. General information

NPI: 1730258922
Provider Name (Legal Business Name): MICHAEL W THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 GENESEE ST OHC EMERGENCY ROOM
ONEIDA NY
13421-2611
US

IV. Provider business mailing address

321 GENESEE ST OHC EMERGENCY ROOM
ONEIDA NY
13421-2611
US

V. Phone/Fax

Practice location:
  • Phone: 315-361-2047
  • Fax: 315-361-2191
Mailing address:
  • Phone: 315-361-2047
  • Fax: 315-361-2191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number177686
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number177686-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: